ARRHYTHMIAS IN MITRAL-VALVE PROLAPSE - RELATION TO ANTERIOR MITRAL LEAFLET THICKENING, CLINICAL-VARIABLES, AND COLOR DOPPLER-ECHOCARDIOGRAPHIC PARAMETERS

Atrial and ventricular arrhythmias have been reported with variable in cidence in symptomatic patients with mitral valve prolapse (MVP). The role of clinical and echocardiographic parameters as predictors for ar rhythmias still needs to be clarified. One hundred nineteen consecutiv e patients (56 women and 63 men, mean age 40 +/- 17 years) with echoca rdiographically diagnosed MVP were examined. A complete echocardiograp hic study (M-mode, two-dimensional, and Doppler) and 24-hour electroca rdiographic monitoring were performed in all patients. Complex atrial arrhythmias (CAAs) included atrial couplets, atrial tachycardia, and p aroxysmal or sustained atrial flutter or fibrillation. Complex ventric ular arrhythmias (CVAs) included multiform ventricular premature contr actions (VPCs), VPC couplets, and runs of three or more sequential VPC s (salves of ventricular tachycardia). The relation between complex ar rhythmias and clinical parameters (age and gender) and echocardiograph ic parameters (left atrial and left ventricular dimensions, anterior m itral leaflet thickness [AMLT], and presence and severity of mitral re gurgitation) was evaluated by multiple logistic regression analysis. C AA were present in 14% of patients and CVA in 30%. According to multip le logistic modeling, CAA correlated separately in the univariate anal ysis with age, presence of MR, and left ventricular and left atrial di ameters; age was the only independent predictor (p < 0.001). CVA, in t he univariate analysis, correlated with age, female gender, left ventr icular end-diastolic diameter, and AMLT; only female gender and AMLT w ere independent predictors in the multivariate analysis (p < 0.01). Th e incidence of mitral regurgitation (59%) was higher than expected in a general population of MVP patients. In conclusion, in this populatio n with MVP, age was independently correlated to CAA, whereas female ge nder and AMLT were independently related to CVA.